Ayachi R, Oualha L, Moussaoui E, Soufi S, Douki N
Odontostomatol Trop. 2016 Sep;39(155):20-6.
Osteitis is an inflammatory disease of bone tissue. Its clinical presentation varies according to the site, presence or absence of pus, duration and etiology. It represents one of the endo-periodontal diseases complication. We report the case of a mandibular osteitis having led to confusion with an ostesarcoma.
A 13-year-old boy was referred to our department for a right low swelling with suspicion of mandible osteosarcoma. The lesion’s evolution was 6 weeks. With the local aggressiveness and the speed evolution, the first diagnosis proposed was a mandibular osteosarcoma. Based on the clinical and radiological data established, the diagnosis of mandibular osteitis on a periapical granuloma was made and the treatment consisted on the causal tooth extraction with curettage of the periapical lesion associated to the prescription of macrolide (ERY®). The clinical follow-up was 6 weeks, a recovery with cessation of clinical signs were noticed.
The differential diagnosis facing the clinical context is an osteitis on a periapical inflammatory cyst and especially mandibular osteosarcoma. For the therapy, it’s a 3 components treatment (etiology, medical and surgical) to obtain a recovery.
骨炎是一种骨组织的炎症性疾病。其临床表现因部位、有无脓液、病程及病因的不同而有所差异。它是牙周炎疾病的并发症之一。我们报告一例下颌骨炎病例,该病例曾被误诊为骨肉瘤。
一名13岁男孩因右侧下颌肿胀被转诊至我科,怀疑患有下颌骨肉瘤。病变发展已有6周。鉴于病变的局部侵袭性和快速发展,最初诊断为下颌骨肉瘤。根据已建立的临床和放射学资料,诊断为根尖周肉芽肿引起的下颌骨炎,治疗包括拔除患牙并刮除根尖周病变,同时开具大环内酯类药物(ERY®)。临床随访6周,发现症状消失,病情痊愈。
结合临床情况进行鉴别诊断时,需考虑根尖周炎性囊肿引起的骨炎,尤其是下颌骨肉瘤。对于治疗而言,需要采取病因治疗、药物治疗和手术治疗这三个方面的综合治疗措施才能实现康复。